- Roxithromycin 300mg tablet orally 1 x1
- Revenin 500mg tablets 1x 4 up to 2 x 4 until fever subside
If there are excessive secretions and sneezing add:
- Loratadine 10mg orally once a day
If there is nasal obstruction add :
- Rhinaction Hypertonic sea water spray1puff 4-6 times daily
Roxithromycin:
Dosage Forms & Strengths:
- 300mg tab, 150mg tab
Trade names :
- Roximac, Roxipharm, Rulid, Roxamed ,Ruxid, Romac
Therapeutic indications:
- Acute pharyngitis, tonsillitis, sinusitis
- Acute bronchitis
- Exacerbation of chronic bronchitis
- Pneumonia
- Skin and soft tissue infections
- Non gonococcal urethritis
- Impetigo
Dose:
- 300mg once a day Or 150mg twice a day
Contraindications:
- Known hypersensitivity to Roxithromycin
Pregnancy: Category B.
Side effects:
- Oral thrush – white, furry, sore tongue and mouth
- Vaginal thrush – sore and itchy vagina and/or discharge
- Nausea, vomiting, stomach pain, diarrhea, flatulence
- Loss of appetite
- Red and/or itchy skin
- Headache, dizziness, ringing in the ears
- Tiredness
- Altered taste.
Paractamol
- Analgesic and antipyretics
- Not anti-inflammatory effect
- Suitable for Temperature between (37.5C – 38.5C)
- Safe under 6 months
Trade names : ( Revanin ,Adol,Panda,Dolocet ,Feverol, panadol )
Concentrations: 500 mg tablet, ,1g tablet ,125 mg/5 ml syrup, 250 mg/5 ml syrup, 125 mg suppositories, 250 mg suppositories,1g/100ml solution for infusion
Dose :
Tablet, capsule :
- 500mg tabs 1-2 tabs /cap every 6 hours
Syrup, suspension :
- < 5year : 125mg/5ml susp (w/2) Every 4 – 6 hours
- 5-12 year : 250mg/5ml susp (w/4) Every 4 – 6 hours
Suppositories :
- <1Y : 125 mg supp Every 8 hours (1 supp x 3 )
- >1Y : 250mg supp Every 8 hours ( 1supp x 3 )
Iv solution 1g/100ml :
- <10kg : 0 .75ml/kg
- >10kg , <50kg : 1.5ml/kg
- >50kg : 100ml Slowly over 15 minute
Maximum dose : 4g daily
Pregnancy and lactation : Paracetamol is the first choice of painkiller in pregnancy and breastfeeding
Loratadine
Available forms:
- Loratan, clara, histal, Klarihist, Loreen, Lorine Lohist, Ramitin:10mg tab, 5mg/5ml syrup
- Tidilor, Claritine, Lorax :10mg tab, 1mg/1ml syrup
- Loratin, Restamine:10mg tab
- Lostamin: 5mg/5ml syrup
Indications:
- Relief of symptoms associated with allergic rhinitis, such as sneezing, nasal discharge (rhinorrhea) as well as ocular itching and burning.
- indicated for the relief of symptoms and signs of chronic urticaria and other allergic dermatologic disorders.
Dose:
- Adults and children 6 years and older who weigh more than 30kg : 1 x tablet once daily
- Adults and children over 12 years of age: 2 teaspoons (10 ml), once a day, with or without food.
- The dosage for children aged 2-12 is by weight:
- Body weight over 30 kg: 2 teaspoons (10 ml), once a day, with or without food.
- Body weight of 30 kg or less: one teaspoon (5 ml), once a day, with or without food.
Pregnancy and breast-feeding :
As a precautionary measure, it is preferable to avoid the use of Loratadine Tablets during pregnancy. Loratadine is excreted in breast milk so preferable to avoid the use in lactation
side effect:
- drowsiness
- headache
- increased appetite
- difficulty sleeping.
Rhinaction Hypertonic sea water spray
- Sea water
- is a natural nasal decongestant spray
- Clearing and purifying solution, combining hypertonic seawater with a complex of 3 essential oils: Ravintsara, Thyme Linalool and Field Mint.
- Enables a reduction in symptoms of congestion, rhinorrhoea (runny nose) and sneezing by eliminating viruses and bacteria from nasal passages through draining effect
- Quickly relieves blocked nose and for up to 8 hours with a regular application of 1 spray per nostril, 6 times a day.
Dose:
- 1 spray per nostril, 6 times a day.
Pregnancy and lactation:
- Save
In Emergency room:
- Give antipyretic:
- Perflgan 1g/100ml intravenous injection :
Dose:
Pediatrics:
- <10kg : 0 .75ml/kg
- >10kg , <50kg : 1.5ml/kg
- >50kg : 100ml Slowly over 15 minute
Adult:
- 100ml Slowly over 15 minute
OR
- Diclofenac sodium injection 75 mg/3ml intramuscular injection :
Dose:
Pediatrics:
- > 1year : 1ml/20kg every 12 hour .
Adult:
- 25 to 75 mg(1-3ml) depending on the severity pain.
- If the pain still severe, you may decide to give a second injection after 6 hours.
- Give Antibiotic:
- Lincomycin 600mg/2ml
Dose:
Pediatrics:
- IV: 10-20 mg/kg/day divided q8-12hr
- IM: 10 mg/kg q12-24hr
Adult:
- IM: 600 mg q12-24hr
- IV: 600-1000 mg q8-12hr; not to exceed 8 g/day
OR
- Ceftriaxone injection
Dose:
Pediatrics:
- 50 mg/kg IM in single dose; not to exceed 1 g
Adult:
- 50 mg/kg IM once
- Persistent or treatment failures: 50 mg/kg IV/IM for 3 days
- Give Antihistamine In sneezing and rhinorrhea :
- Allerfin 10mg/ml IM injection :
Dose:
- 1-5 year : 25-5mg (½ ml )
- 6-12 year: 5-10mg (1ml )
- Adult : 10-20 mg (1-2 ml )
Acute sinusitis
Presentation :
- Purulent nasal discharge
- Nasal congestion or obstruction
- Facial congestion or fullness
- Facial pain or pressure
- Decreased sense of smell
- Fever
- Headache
- Ear pain
- fullness; halitosis; dental pain; cough; fatigue
Examination:
- Purulent nasal secretions
- Purulent posterior pharyngeal secretions
- Mucosal erythema
- Tenderness overlying sinuses
Lines of management :
- Antipyretics
- Antibiotics
- Symptomatic treatment:
- In nasal obstruction : use nasal decongestant
- In excessive secretions and sneezing : use antihistamine
- If not respond : Intranasal Corticosteroids :
- Helpful in reducing mucosal swelling of inflamed tissue and facilitating sinus drainage because of an anti-inflammatory effect